Psychoanalytic Therapy: Definition & Techniques

Medically reviewed by Andrea Brant, LMHC
Updated April 30, 2024by BetterHelp Editorial Team

Also known as psychodynamic therapy, psychoanalytic therapy is a type of therapy that focuses on the dialogue between the therapist and client to support the expression of repressed emotions that may date back to childhood. This type of counseling, such as psychodynamic therapy online, is often used to treat mental health conditions like anxiety and depression.

The psychoanalytic therapy approach explores the underlying causes behind mental health difficulties to help identify and strategize healthy ways of moving forward and regaining a solid sense of self.

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The history of this practice 

The history of psychodynamic psychotherapy is rooted in the subject of psychoanalysis. The origins of psychoanalytic therapy were developed by Sigmund Freud in the late 1890s when he worked in a children's hospital. He noticed that many children had symptoms of poor mental health with no apparent cause and that some mental processes were subconscious. These thoughts were considered to be unconscious thoughts from the unconscious mind.

Freud later received a grant to work with Jean-Martin Charcot, a pioneer in the nascent field of psychology. Charcot had developed a hypnotism technique to help patients experiencing hysteria, which was conventionally considered to be one of several psychological disorders.

Freud's role in psychoanalysis 

Freud continued to study hypnosis and went on to work with a colleague named Josef Breuer. Breuer and Freud collaborated on a book called "Studies on Hysteria," which brought to light specific therapeutic techniques used in hypnosis. Freud developed talk therapy as an alternative to hypnosis and began working with psychoanalytic techniques. He proposed the psychoanalytic theory that talking about problems could be a mental health treatment that significantly relieves the anguish of individuals experiencing emotional distress. Freud believed that the therapist-patient relationship would build dialogue to help clients heal from suppressed emotions. 

Many of Sigmund Freud's theories are considered outdated by modern practitioners of clinical psychology in the United States and worldwide. However, the ideas and theories behind traditional psychoanalysis have been profoundly impactful in the field. The psychoanalytic theory that Freud founded, followed by Anna Freud, was one of the bases of modern therapy, and many types of therapy stemmed from it.

How does psychoanalytic therapy work? 

The psychoanalysis therapy practice is the "classic" form of talk therapy often portrayed by media and popular culture. This therapy encourages patients to explore a full range of emotions and become aware of their unconscious thoughts. Furthermore, a psychoanalytic therapist may conduct in-depth talk therapy to explore the past experiences of their patients to see how they may be affecting their unconscious thoughts and feelings.

Psychoanalytic therapists might attempt to talk through repressed memories and locate their origin. The psychoanalytic theory revolves around the idea that many emotional responses are due to the unconscious mind and may need to be brought into conscious awareness. Patients may experience several types of mental health problems that can be helped through this therapeutic process of psychoanalysis. Sigmund Freud believed treatment and healing would most likely occur once patients consciously understood their feelings and thoughts. In some cases, psychoanalytic therapy may utilize features of attachment theory to understand how adverse childhood experiences may impact an individual as an adult. 

Active listening and note-taking are two techniques that psychoanalytic therapists might utilize. During their psychoanalytic therapy sessions, the patient may spend time talking about their concerns, childhood, interpersonal relationships, and any events that could have led to their current emotional state. The therapist might then try to find self-destructive patterns and maladaptive thinking. For example, repetitive behaviors and thoughts that may show a patient are "stuck" in a particular mode of thought or situation might be highlighted and treated. This type of therapeutic relationship can help patients who experience both somatic symptoms and symptoms of psychological distress, such as depressive symptoms. 

Part of psychoanalytic therapy's purported strength is that patients often work through their mental turmoil and adverse experiences by speaking about them. Freud referred to this as the "talking cure." Psychoanalysis, similar to behavior therapy, aims to improve the mental health of the patient and lessen the psychological symptoms. How is behavior therapy different than psychoanalysis? Psychoanalytic therpy targets to understand the unconscious mind of the patient while behavior therapy focuses on the action-oriented approach to improve outcomes.

Psychoanalytic therapy

Multiple peer-reviewed clinical psychology studies have shown the effectiveness of psychoanalytic therapy. For example, World Psychiatry conducted a meta-analysis from high-quality sources on the results of psychoanalytic therapy. In many cases, psychoanalytic therapy was more effective than other therapies in treating depressive symptoms. 

Another article published by American Psychologist conducted a meta-analysis on this topic. It concluded that psychoanalytic therapy often significantly reduced depressive symptoms and symptoms related to personality and mood disorders.

The latest evidence-based research, reviewed and conducted by medical reviewers and board-certified physicians, continues to boast the effectiveness of psychoanalytic therapy for various conditions. You can find more information about the latest evidence-based research on psychoanalytic therapy from the American Psychoanalytic Association. For additional content, psychoanalytic societies like the Vienna Psychoanalytic Society (formerly the Wednesday Psychological Society) offer up-to-date research and news.

Who might benefit from psychoanalytic therapy?

The primary goal of psychodynamic psychotherapy is often to significantly reduce the symptoms of various mental health conditions or emotional distress. Many studies have concluded that psychodynamic therapy can be effective for those living with depressive symptoms. However, people experiencing anxiety, panic disorder, personality disorders, eating disorders, somatic symptoms, or other stress-related conditions may also benefit.

Even if you do not live with these conditions but experience issues with your current behavior or psychological distress, you may be able to find treatment and support through psychodynamic psychotherapy. Many emotional responses and self-destructive behaviors could be revealed through challenges in interpersonal relationships and daily life stressors. 

Before choosing a form of therapy, seek professional medical advice or referral. Talk with a qualified therapist about your symptoms and concerns to receive guidance and support. There may be another type of treatment than psychoanalytic therapy that your therapist feels would better suit your needs, so discussing your goals beforehand can be valuable. 

Psychoanalytic techniques and concepts 

Below are a few psychoanalytic techniques and concepts used in this form of therapy. 

Free association and dream interpretation

One technique used in psychoanalytic therapy involves wordplay. The free association technique developed by Freud involves a client speaking the first thought that comes to mind when a therapist offers them a word or phrase. In psychoanalytic therapy, the therapist may employ free association and then interpret why the associations were made or what unconscious thoughts or feelings the client may have. 

Dream analysis, or dream interpretation, could also be utilized. Dream analysis can involve a client recounting a dream or dreams that they have had, including recurring, vivid, or distressing dreams. The psychoanalyst might consider the cause of these dreams based on the subconscious theory. For example, there may be repressed memories or subconscious urges expressed.

Psychoanalytic therapy often considers dreams to be powerful manifestations of our subconscious mind. For example, you might not be fully aware that you are harboring resentment towards an individual but have a dream where you are yelling or angry at this person. When awake, you may discuss the dream with your therapist and learn more about where these emotions might have stemmed from. 

In psychoanalytic therapy, your analyst may help you understand the forces behind dreams that may seem confusing or disturbing. The therapist could try to find repetitive themes and objects that might be symbolic. For instance, you might repeatedly dream of flying away from your home. Your therapist may interpret this as an urge to detach, move, or avoid conflict. Not all psychologists use dream interpretation, but reaching out to a psychoanalytic provider can help you learn more about available resources. One may opt for object relations therapy since it is a variation of Sigmund Freud's psychoanalytic theory, which influences psychoanalytic therapy.

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Transference

In psychoanalytic therapy, patients often discuss individuals who hurt or otherwise profoundly affected them. This discussion can provide the therapist an entryway to discuss the idea of "transference." In psychoanalytic therapy, transference is a negative occurrence that involves taking feelings about one person and redirecting them to another. For instance, someone may have issues with a parent and transfer these feelings onto their significant other through arguments. 

Therapists offering transference analysis therapy might work with patients to break down transference to understand why it occurs and how to reduce this habit. Therapists may use transference analysis to improve maladaptive behaviors or cognitive distortions.

Overcoming defense mechanisms

During this therapy, your therapist may help you discover and overcome defense mechanisms. Defense mechanisms often occur as a defensive measure that shields a person from the stress of facing internal and external stressors. Once you are aware of maladaptive behaviors, you may be able to react constructively to challenging scenarios. 

Should I try psychoanalytic therapy? 

Psychoanalytic therapy may not work for everyone. It can involve probing into the unconscious mind and suppressed emotions, which may be vulnerable and scary for many. However, these interventions can be therapeutic, so if you believe they may benefit you, consider searching for a psychoanalytic therapist in your area or online.  

How to find a psychoanalytic therapist 

Psychoanalytic therapists may have specific training in psychoanalytic therapy, including knowledge of the latest theories and methods. They might also have experience practicing psychoanalytic therapy. Look for a therapist with an up-to-date license to practice in your state. You can learn more about what makes a qualified psychoanalyst by reviewing information from the American Psychoanalytic Association.

When searching for a therapist, try to find someone you connect with and trust. Therapy can be a vulnerable process, so it may be difficult to talk to a therapist you do not trust. You might try multiple psychotherapists before finding one you feel comfortable with. Over time, delving into deeper topics may become easier as you strengthen your therapist-patient relationship.

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Counseling options 

Therapy can be a personal experience, and each person may seek different results. If you think psychoanalytic theory aligns with your goals for therapy, this treatment method could help you uncover your unconscious thoughts and memories that may influence how you manage daily life. You can try this form of therapy in person or online. 

Online psychodynamic therapy has been studied to measure its efficacy compared to in-person therapy. For example, in a study published in the Journal of the American Psychoanalytic Association, psychotherapists reported that, despite the technical and relational challenges of remote sessions, they felt as emotionally connected to their clients as they did in traditional in-person sessions.

Online therapy can allow you the convenience of attending therapy from home or any location with an internet connection, which might be beneficial if you struggle to open up with a therapist in person. If you're interested in trying this counseling method, consider signing up for a platform like BetterHelp, which offers a growing database of experienced counselors licensed to practice various forms of therapy, including psychoanalysis and other popular forms of treatment like cognitive-behavioral therapy (CBT). 

Takeaway

Your mental health can matter as much as your physical well-being. Many types of counseling are available for treating stress, mental health symptoms, and psychological conditions. If you're looking to start psychoanalytic therapy or another form of counseling, consider reaching out to a mental health professional for further information and guidance.

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